HB 0055

CS

CHAMBER ACTION

1	The Finance & Tax Committee recommends the following:
2
3	Council/Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to the voter-approved indigent care
7	surtax; amending s. 212.055, F.S.; authorizing small
8	counties having a specified millage value to levy an
9	indigent care surtax subject to referendum approval;
10	providing limitations; providing procedures; specifying
11	authorized uses of surtax proceeds; authorizing issuance
12	of bonds for certain purposes; providing a maximum tax
13	rate; providing an effective date.
14
15	Be It Enacted by the Legislature of the State of Florida:
16
17	Section 1.  Subsection (7) of section 212.055, Florida
18	Statutes, is amended to read:
19	212.055  Discretionary sales surtaxes; legislative intent;
20	authorization and use of proceeds.--It is the legislative intent
21	that any authorization for imposition of a discretionary sales
22	surtax shall be published in the Florida Statutes as a
23	subsection of this section, irrespective of the duration of the
24	levy. Each enactment shall specify the types of counties
25	authorized to levy; the rate or rates which may be imposed; the
26	maximum length of time the surtax may be imposed, if any; the
27	procedure which must be followed to secure voter approval, if
28	required; the purpose for which the proceeds may be expended;
29	and such other requirements as the Legislature may provide.
30	Taxable transactions and administrative procedures shall be as
31	provided in s. 212.054.
32	(7)  VOTER-APPROVED INDIGENT CARE SURTAX.--
33	(a)1.  The governing body in each county that has a
34	population of fewer less than 800,000 residents may levy an
35	indigent care surtax pursuant to an ordinance conditioned to
36	take effect only upon approval by a majority vote of the
37	electors of the county voting in a referendum. The surtax may be
38	levied at a rate not to exceed 0.5 percent, except that if a
39	publicly supported medical school is located in the county, the
40	rate shall not exceed 1 percent.
41	2.  Notwithstanding subparagraph 1., the governing body of
42	any county for which the value of a mill in the county is no
43	more than $1 million, based on the property valuations and tax
44	data annually published by the Department of Revenue under s.
45	195.052, and which levied 8 mills or more for county purposes
46	during the previous fiscal year, may levy an indigent care
47	surtax pursuant to an ordinance conditioned to take effect only
48	upon approval by a majority vote of the electors of the county
49	voting in a referendum. The surtax may be levied at a rate not
50	to exceed 1 percent.
51	(b)  A statement that includes a brief and general
52	description of the purposes to be funded by the surtax and that
53	conforms to the requirements of s. 101.161 shall be placed on
54	the ballot by the governing body of the county. The following
55	questions shall be placed on the ballot:
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57	FOR THE. . . .CENTS TAX
58	AGAINST THE. . . .CENTS TAX
59
60	(c)1.  The ordinance adopted by the governing body
61	providing for the imposition of the surtax must set forth a plan
62	for providing health care services to qualified residents, as
63	defined in paragraph (d). The plan and subsequent amendments to
64	it shall fund a broad range of health care services for indigent
65	persons and the medically poor, including, but not limited to,
66	primary care and preventive care, as well as hospital care. It
67	shall emphasize a continuity of care in the most cost-effective
68	setting, taking into consideration a high quality of care and
69	geographic access. Where consistent with these objectives, it
70	shall include, without limitation, services rendered by
71	physicians, clinics, community hospitals, mental health centers,
72	and alternative delivery sites, as well as at least one regional
73	referral hospital where appropriate. It shall provide that
74	agreements negotiated between the county and providers shall
75	include reimbursement methodologies that take into account the
76	cost of services rendered to eligible patients, recognize
77	hospitals that render a disproportionate share of indigent care,
78	provide other incentives to promote the delivery of charity
79	care, and require cost containment, including, but not limited
80	to, case management. The plan must also include innovative
81	health care programs that provide cost-effective alternatives to
82	traditional methods of service delivery and funding.
83	2.  In addition to the uses specified or services required
84	to be provided under this subsection, the ordinance adopted by a
85	county adopting an ordinance pursuant to subparagraph (a)2. may
86	pledge surtax proceeds to service new or existing bond
87	indebtedness incurred to finance, plan, construct, or
88	reconstruct a public or not-for-profit hospital in such county
89	and any land acquisition, land improvement, design, or
90	engineering costs related to such hospital, if the governing
91	body of the county determines that a public or not-for-profit
92	hospital existing at the time of issuance of the bonds
93	authorized under this subparagraph would, more likely than not,
94	otherwise cease to operate. The plan required under this
95	paragraph may, by an extraordinary vote of the governing body of
96	such county, provide that some or all of the surtax revenues and
97	any interest earned must be expended for the purpose of
98	servicing such bond indebtedness. Such county may also use the
99	services of the Division of Bond Finance of the State Board of
100	Administration pursuant to the State Bond Act to issue bonds
101	under this subparagraph. A jurisdiction may not issue bonds
102	under this subparagraph more frequently than once per year. Any
103	county that has adopted an ordinance under subparagraph (a)2. at
104	the time any bonds authorized in this subparagraph are issued
105	retains the authority granted under this subparagraph throughout
106	the terms of such bonds, including the terms of any refinancing
107	bonds, regardless of any subsequent increase in taxable value
108	which results in the value of a mill in the county exceeding $1
109	million.
110	(d)  For the purpose of this subsection, "qualified
111	residents" means residents of the authorizing county who are:
112	1.  Qualified as indigent persons as certified by the
113	authorizing county;
114	2.  Certified by the authorizing county as meeting the
115	definition of the medically poor, defined as persons having
116	insufficient income, resources, and assets to provide the needed
117	medical care without using resources required to meet basic
118	needs for shelter, food, clothing, and personal expenses; not
119	being eligible for any other state or federal program or having
120	medical needs that are not covered by any such program; or
121	having insufficient third-party insurance coverage. In all
122	cases, the authorizing county shall serve as the payor of last
123	resort; or
124	3.  Participating in innovative, cost-effective programs
125	approved by the authorizing county.
126	(e)  Moneys collected pursuant to this subsection remain
127	the property of the state and shall be distributed by the
128	Department of Revenue on a regular and periodic basis to the
129	clerk of the circuit court as ex officio custodian of the funds
130	of the authorizing county. The clerk of the circuit court shall:
131	1.  Maintain the moneys in an indigent health care trust
132	fund.
133	2.  Invest any funds held on deposit in the trust fund
134	pursuant to general law.
135	3.  Disburse the funds, including any interest earned, to
136	any provider of health care services, as provided in paragraphs
137	(c) and (d), upon directive from the authorizing county.
138	4.  Disburse the funds, including any interest earned, to
139	service any bond indebtedness authorized in this subsection upon
140	directive from the authorizing county, which directive may be
141	irrevocably given at the time the bond indebtedness is incurred.
142	(f)  Notwithstanding any other provision of this section, a
143	county may not levy local option sales surtaxes authorized in
144	this subsection and subsections (2) and (3) in excess of a
145	combined rate of 1 percent or, if a publicly supported medical
146	school is located in the county or if the county adopted an
147	ordinance under subparagraph (a)2., in excess of a combined rate
148	of 1.5 percent.
149	Section 2.  This act shall take effect upon becoming a law.

CODING: Words stricken are deletions; words underlined are additions.